February 6, 2012

Several years ago I posted a poll on a diet support forum seeking to understand the strategies successful dieters used to maintain weight losses they'd achieved using low carb diets. The answers I got were very helpful to other people who hoped to be able to maintain their weight loss.

Now I'd like to post the same questions here to those of you who have diabetes or prediabetes and who have been able to successfully use a dietary strategy that involves cutting back on carbs for three or more years.

Please only answer if you have been using some form of carb restriction for three years or more. It doesn't have to be a formal low carb diet, but I'm looking for a dietary change that you have pursued for three or more years that has managed to either a) take off weight and keep most of it off or b) keep your blood sugar under 6.5% almost the entire time.

Post your answers in the "comments" section of this post which you can find by clicking on the "comments" link at the bottom of the post. I'll post my answers to give you an example of what I'm looking for.

1. Did you make changes in your diet after you first reached your weight loss or blood sugar control goal?

2. How much weight have you regained at any one time and how did you deal with it?

3. How badly has your blood sugar gone off course?

3. What behaviors did you adapt that helped you maintain your weight and blood sugar goals?

4. How high a carb level do you eat at? Does this level stay constant or does it fluctuate?

5. Did you ever get help from a doctor with metabolic issues that helped with weight or blood sugar control after you first regained control?

6. How important is exercise to your ability to maintain?

7. What tips would you give people currently beginning the process of changing their diet to improve either weight or blood sugar control that might help them achieve successful maintenance?

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comments:

1. Did you make changes in your diet after you first reached your weight loss or blood sugar control goal?

Yes. I ate a strict Bernstein diet from 1998-2001 but burnt out and regained the weight I lost and had bad control for the next year after blowing it off. When I got back on track in late 2002 I became more flexible about eating small portions of off-plan foods now and then. Eventually I added metformin and then insulin which allowed me to eat more carbs and still get better blood sugars.

2. How much weight have you regained at any one time and how did you deal with it?

Since 2002 when I lost 30 lbs, I have only regained 7 pounds at any time, currently I am 1 pound over goal. When I gain weight I cut back on carbs count calories too.

3. How badly has your blood sugar gone off course?

I have only had two readings over 5.8% since 2003. Both were 6%. My best reading was 5.5%.

3. What behaviors did you adapt that helped you maintain your weight and blood sugar goals?

I make myself test after eating anything I know is too high in carbs so that I can see the ugly number on the meter. I weigh myself daily, too. I learned over time that because of the nature of my diabetes fast acting insulin at meals is very helpful to me. It turns out that my sugars actually go up long term on a very low carb diet without insulin. I have to eat 20+ grams of carb at one time to use fast acting insulin safely so I will alternate very low carb meals without insulin with meals with more carbs with.

4. How high a carb level do you eat at? Does this level stay constant or does it fluctuate?

The last couple years I have found I do better at about 100 g a day rather than lower. After years of eating below 60 g a day, 100 grams feels like a major carb out, but it really isn't. 5. Did you ever get help from a doctor with metabolic issues that helped with weight or blood sugar control after you first regained control?

Yes. I've improved my blood sugar control with Metformin, insulin, prandin (for a while, then had to stop it) and currently experimenting with Co-enzyme Q10 which seems to be making a small improvement, too.

6. How important is exercise to your ability to maintain?

It has never made any difference in either my blood sugar control or weight. I exercise when I can for fitness benefits, mostly treadmill and walking because of problems with my back and fragile tendons.

7. What tips would you give people currently beginning the process of changing their diet to improve either weight or blood sugar control that might help them achieve successful maintenance?

Don't be too rigid! Don't let yourself feel deprived because that is what leads to burnout and completely crashing off your diet. For me it's a continual ebb and flow. Some days are really good, some okay, but overall it works out to good enough, and most importantly, I'm still at it almost 9 years later without any crashes.

1) No, lost about 30 pounds after starting a lower car4b diet.2) 5 pounds while on a week's vacation. Dropped it without trying after getting home to normal routine.3) I think the highest my blood sugar has gone was probably around 112. I never had blood sugar issues and only test occassionaly.4) My carb level is probably less than 30% of calories. It does fluctuate on a daily basis. I conciously avoid wheat, sugar, and corn products.5) No6) Not that important7) This may sound crazy but I feel it is important to learn the science behind carbohydrate metabolism. Read this blog and the books recommended. Your diet change will be much easier when you have a clear understanding and you won't be sidetracked by bad information. Bad information is way more prominent than good information.

3. What behaviors did you adapt that helped you maintain your weight and blood sugar goals? Low carb

4. How high a carb level do you eat at? Does this level stay constant or does it fluctuate?50NC it fluctuates. I will go up if Im on a trip and it will go down if the weight starts to go up.

5. Did you ever get help from a doctor with metabolic issues that helped with weight or blood sugar control after you first regained control? Nope

6. How important is exercise to your ability to maintain? I dont exercise tho I know I should

7. What tips would you give people currently beginning the process of changing their diet to improve either weight or blood sugar control that might help them achieve successful maintenance? Realize one is going to be doing low carb in one way or another for the rest of their lives.

1. If anything, I eat lower carb than I did when first diagnosed (and when I first got things under control). Controlling blood sugar allowed me to lose 2-3 jeans sizes (16+ down to 10 or 12). I maintained that more or less on autopilot. About 10 years later, I lost another 15 pounds, probably as a result of getting some dental work done that eliminated some residual inflammation. I know average a size 8 in jeans (due to sizing vagaries, a whole nother rant, it's actually 6-10, depending on cut and manufacturer).

2. I don't own a scale, but if I notice jeans getting tight, I cut back on carbs a little, especially between meal snacks.

3. I think my highest A1c in the past 15 years is a 6.1 & lowest is 4.6; I'm mostly in the mid 5s. (Well, except for the time I got a prednisolone dose pack for poison ivy, but that was a minor blip!)

3a. (You have two 3s). I never eat a carb I don't like. It was easy to cut out potatoes & rice, for instance. I don't buy fruit much (and not out of season), but occasionally cadge orange sections and the like from friends. Bites of sugary desserts are a much bigger challenge for me, and I don't always rise to the challenge, alas.

4. I worry more about the amount of carbs in a meal than about the overall daily allotment. When I bother to record things, it fluctuates from 30-120 grams.

5. No medical help. I don't take any meds and never have.

6. Exercise is irrelevant to me (well, to my control). I have other medical issues which sometimes limit the kinds of exercise I can do. While exercise is obviously beneficial to general health, I don't want my diabetes control to be dependent on a level of exercise I might not be able to maintain.

7. At the start, it's important to focus on what you can eat, not just on what you can't eat. Be willing to try new foods and new preparations. And think about things you like that are naturally low carb and that you don't always eat. I think I got through my months immediately after diagnosis by eating large quantities of avocado. (The only reason I'm not saying unlimited is that avocado consumption is self-limiting.)

1. Did you make changes in your diet after you first reached your weight loss or blood sugar control goal? A couple of weeks after going on an insulin pump, I dropped my carbohydrate intake from 180 a day to 80 a day.

2. How much weight have you regained at any one time and how did you deal with it?

About 15 pounds. I maintained the carb limit but made a serious effort to eat less.

3. How badly has your blood sugar gone off course?None. Nada ZipFirst A1c on a pump 5.7. Second 5.5.Next 20 A1c's 4.9 to 5.4. My last 3 have been 5.0, 5.0, 5.0, including the one today!

3. What behaviors did you adapt that helped you maintain your weight and blood sugar goals?

A food scale, and 18 years experience counting carbohydrates.

4. How high a carb level do you eat at? Does this level stay constant or does it fluctuate?

80 average. Once a month or so I give myself a diabetes "vacation day", and eat out and have about 120 grams of carbohydrate.

5. Did you ever get help from a doctor with metabolic issues that helped with weight or blood sugar control after you first regained control?

Twice. I lost so much weight that my synthroid dosage was too high, resulting in unexplained lows. A new synthroid dosage and 3 weeks to adjust took care of the problem. I have been hypothyroid for 32 years, and my thyroid quit completely 15 years ago.

6. How important is exercise to your ability to maintain?

It is good for my general health. However, whether walking 5 miles as fast as I can in nice weather, or getting almost no exercise at all when snowed in in the winter, my glucose control is the same - exceptional.

7. What tips would you give people currently beginning the process of changing their diet to improve either weight or blood sugar control that might help them achieve successful maintenance?Posted by Jenny at 3:23 PM

I am 61, and a type 2. I lost 35 pounds in 8 months limiting my carbohydrates. Almost 5 years later, I am down 48 pounds total. It is not a diet, it is a lifestyle I will continue for the rest of my life (or until it is out of my hands).

1. Did you make changes in your diet after you first reached your weight loss or blood sugar control goal?

I pretty reached my goal by sticking to a Bernstein-style diet, although I don't really measure things--I like to refer folks to Dr. Helen Hilts's rule of thumb: "No roots, no fruits, no grains, no milk." Hard to overdo carbs that way. Last December, I had a stent inserted into one of my coronary arteries; since then, I've been experimenting with "no dairy," and upping my consumption of raw greens, in an attempt to better control inflammation.

2. How much weight have you regained at any one time and how did you deal with it?

During the first 9 months after diagnosis, I dropped 65 pounds (from 220 to 155), on a 6-foot frame. At 155, I looked emaciated. With exercise, I gained back 25 over the next couple of years (principally muscle in my thighs and calves, and some in the shoulder and arms, as well). I have vascillated between 180 and 185 for the past year and a half or so.

3. How badly has your blood sugar gone off course?

Since the month after I discovered Dr. Bernstein, my monthly BG average (testing 7-8 times a day) has never exceeded 100, and for much of the time has been 90 or less. My A1c, which was 6.5 at diagnosis, has been under 6 since November 2008 (9 months later)--and, except for one (unexplained) excursion to 5.8 last March, has bounced around between 5.3 and 5.5.

3. What behaviors did you adapt that helped you maintain your weight and blood sugar goals?

I continue to test often, because I'm slightly compulsive that way, because I eat in restaurants a fair amount and it lets me check out new dishes every now and then, and because it keeps me honest. Shortly after diagnosis, I bought a bike and a stand, and I ride that 3-4 times a week. A couple of years ago, I started going down (and then back up) the stairs from and to the 24th floor on a daily basis during the week.

4. How high a carb level do you eat at? Does this level stay constant or does it fluctuate?

Hard to say, because I don't measure, but I'd guesstimate 30-60 grams a day. The level stays more or less within that range.

5. Did you ever get help from a doctor with metabolic issues that helped with weight or blood sugar control after you first regained control?

No. My PCP doesn't think that, with an A1c of less than 6.0, I have any blood sugar control issues.

6. How important is exercise to your ability to maintain?

My perception is that it helps with BGs--but that good, vigorous walking is more effective than other forms of exercise. If I take a two- or three-mile walk at a good clip, my BGs really benefit for a couple of days. I don't know that exercise has any effect on my weight, but it does help keep me fit.

7. What tips would you give people currently beginning the process of changing their diet to improve either weight or blood sugar control that might help them achieve successful maintenance?

With BGs: I favor continued testing--even after you reach your goas, to keep you on your toes. Don't stress over one (or a few) odd high readings, though--so many things can affect your blood sugar levels that it can be hard to pinpoint cause. Watch for longer-term trends, and then see if you can suss out whatever issue needs to be addressed. Don't beat yourself up over a lapse--just get back on that wagon and keep pluggin'.

I was diagnosed with diabetes in 2004 at age 49 and spent a year testing 4-6 times a day to see what I could eat without my blood glucose going too high (by the standards used on this site). I lost weight without trying and became an athelete, doing triathlons (mostly short ones, but my longest was a half ironman).

1. Did you make changes in your diet after you first reached your weight loss or blood sugar control goal?

No, I have stuck to what got me to my goal.

2. How much weight have you regained at any one time and how did you deal with it?

In the past three years I've regained most of the weight that I lost. The causes were menopause and not being able to keep up my athletic training because my husband was diagnosed with Parkinson's disease and dementia. The important thing is that I have kept my blood glucose under 6.0. In the last 7 years I have had only one A1c test over 6.0 and that was 6.1.

This past summer I decided to go on Metformin. I thought my A1c had probably crept up, but it was actually still 5.8 before I started the medication. I had to keep increasing my dose before it had any effect at all, but now on 1000 mg of extended release twice a day I am slowly losing weight. I am also shifting to a somewhat more paleo diet.

3. How badly has your blood sugar gone off course?

The worst A1c in the last 7 years was 6.1

3. What behaviors did you adapt that helped you maintain your weight and blood sugar goals?

I got out of the habit of eating any rice, potatoes, pasta, or bread. I do look for clever substitutes--the cauliflower crust pizza I made tonight tasted wonderful

4. How high a carb level do you eat at? Does this level stay constant or does it fluctuate?

I haven't calculated or tested much since that first year.

5. Did you ever get help from a doctor with metabolic issues that helped with weight or blood sugar control after you first regained control?

My doctor is very impressed and has no further advice to give.

6. How important is exercise to your ability to maintain?

I love my exercise, but as I do less not much has changed.

7. What tips would you give people currently beginning the process of changing their diet to improve either weight or blood sugar control that might help them achieve successful maintenance?

What worked for me was the feeling of control I got from the idea "My body, my science experiment."

1. Did you make changes in your diet after you first reached your weight loss or blood sugar control goal? No mostly kept on a very low carb life style.

2. How much weight have you regained at any one time and how did you deal with it? None. Started about 16 Lbs above my ideal wt and lost it all. 152 Now.

3. How badly has your blood sugar gone off course? It stay very good usually under 90 unless I really screw up. A1c under 5 I am on insulin Levomir 3u am and 3u pm and regular 3units with meals. Very sensitive to Insulin and any carbs really shoot my bs up.

3. What behaviors did you adapt that helped you maintain your weight and blood sugar goals? Stay away from the white stuff.

4. How high a carb level do you eat at? Does this level stay constant or does it fluctuate? Under 20 Very little

5. Did you ever get help from a doctor with metabolic issues that helped with weight or blood sugar control after you first regained control? No, other than Atkins book and Bernsteins book

6. How important is exercise to your ability to maintain? I ski and ride a bike and do some resistance exercise but am not very compulsive about it.

7. What tips would you give people currently beginning the process of changing their diet to improve either weight or blood sugar control that might help them achieve successful maintenance?Track your blood glucose so you know what pushes it up. Go on an Atkins induction to start or Bernsteins 6-12-12 They work!

1. Did you make changes in your diet after you first reached your weight loss or blood sugar control goal? I've tried to stay about the same. About 30 grams of carbs a day (6-12-12 per Bernstein)except for one day every 7-10 days when I eat what I want.

2. How much weight have you regained at any one time and how did you deal with it?My weight has remained low since. I rarely weight myself, though. I DO think calories count (not just carbs) and although I don't count calories, I eat in a way to maintain a lower weight.

3. How badly has your blood sugar gone off course?On the days I eat what I want, my BGs are not normal. Still, I know I can't do the very low carb every day without knowing I'll have a break. On VLC days, I have normal BGs. The off days haven't ruined my A1Cs (They're 5.7, 5.8) but this might not work for all.

3. What behaviors did you adapt that helped you maintain your weight and blood sugar goals?

30 grams of carbs almost all days, metformin, Low carb paleo diet, no eating between meals ever, 4 days a week of intense exercise (which I have finally come to enjoy), some planned days off.

4. How high a carb level do you eat at? Does this level stay constant or does it fluctuate?30 grams 6 days a week, 1 day at 100-200 grams.

5. Did you ever get help from a doctor with metabolic issues that helped with weight or blood sugar control after you first regained control?No help from a doctor. I read a lot and try things that I read and use a glucometer and A1Cs to see the results.

6. How important is exercise to your ability to maintain?Very important for weight control and BGs.

7. What tips would you give people currently beginning the process of changing their diet to improve either weight or blood sugar control that might help them achieve successful maintenance?

Be willing to experiment and see what works for you, read the literature and become your own advocate, don't kid yourself, read Blood Sugar 101, Bernstein

1. Did you make changes in your diet after you first reached your weight loss or blood sugar control goal?

I can't say that I followed a strictly low carb diet, but compared to what I ate before, it was! I followed a variation of Prevention's Low Carb Diabetes Diet, which allowed for 125 grams/day. I was put on metformin after diet and exercise alone failed to bring my numbers down, and I'm still taking 1000 mg/day.

I've been allowing more starch carbs in my diet currently; it has not seemed to affect my blood glucose numbers, and my a1c has stayed in the 5% range. But when I was losing and effectively maintaining, I limited my bread/starchy veg, dairy, and fruit carbs to 15 grams/day each (45 total). About 30 grams of carb went toward carbs in nuts, sauces, and a little dark chocolate. The rest was non-starchy vegetables.

My macronutrient breakdown, when I was tracking, averaged about 50% fat (mostly healthy, from nuts), 20-30% protein, and 20-30% carbohydrate.

2. How much weight have you regained at any one time and how did you deal with it?

My initial loss was 83 pounds, but I was training very hard for my first triathlon. When I eased back on my training regimen, 10 pounds popped right back on. I was able to maintain the 73 pound loss for nearly 2 years. But during the past year, my weight has been drifting up. So net loss is currently 50 pounds.

3. How badly has your blood sugar gone off course?

I've been a member of the 5% club since 2009! So not too badly. I think the worst post-meal readings I've seen have been in the 150 range, and that's rare for me.

3. What behaviors did you adapt that helped you maintain your weight and blood sugar goals?

Hmmm...can't say that the weight maintenance has been going well, but I stay pretty strict with making sure what I do eat stays in line with my blood sugar goals. Like Jenny, I make myself test after eating things I know are too high in carbs. I also use exercise to help regulate my blood sugar levels. I enjoy participating in athletic events (running races, triathlons) and have a goal of one per quarter, so these give me incentive to keep consistent with exercise.

4. How high a carb level do you eat at? Does this level stay constant or does it fluctuate?

See item #1. About 125-135 grams/day when I'm on track.

5. Did you ever get help from a doctor with metabolic issues that helped with weight or blood sugar control after you first regained control?

My doctor prescribed metformin, and I was able to have 3 sessions with a diabetes educator and nutritionist to work on my treatment goals.

6. How important is exercise to your ability to maintain?

Absolutely critical! More so for maintaining even blood sugar levels than for weight, but I'm sure I would have regained more had I not been exercising.

7. What tips would you give people currently beginning the process of changing their diet to improve either weight or blood sugar control that might help them achieve successful maintenance?

Read Jenny's Blood Sugar 101 web site! Inform yourself. Try to find some form of exercise that you enjoy, and build on those. And ease into exercise - I don't know how many times I tried to rush into exercise, and then quit because it was too hard. It doesn't take a lot of strenuous exercise to make a difference in blood glucose numbers - just consistency. My diabetes educator prescribed 30 minutes per day, 5 days per week, and said it was as important as medication. (It doesn't all have to be in the same chunk, either - you can break it up through the day.)

Sarah submitted the following set of answers via email. (If you are having problems with blogger not accepting your comments, you can do the same.)

1.Instead of "low carb" bread and pasta, I cut out grains altogether.

2.Initially I went from 150lb to 120lb (I've been gaining and losingthose 30lb since the 4th grade - in 6th grade I lost them with avegetarian, whole grains based diet, in high school by noteating food,and in college by living in Europe).

Since that initial weight loss, I gain between 10-15 lb up from 120anytime anything goes wrong (particularly if I catch the flu).

3.The highest BG I ever tested was >140; for a while I was getting lows in the mid-20s (hypos accompanied by physical/mental meltdowns).

3b.I partly credit 5-HTP for my switch from the carb-controlled diabetic diet that my endocrinologist had originally recommended, to the trueLC diet I follow now. I never had a sweet tooth, but 5-HTP made allcarbs seem non-edible.

4.All of my carbs come from vegetables and fruit. I aim to stay below 20 grams in a meal, more if I'm going to be exercising soon after eating.

Constant carb levels are very important for me. This is probably still the area where I could improve my diet most (fish and kale soup is not the carb equivalent of vegetable beef soup, which is not the carb equivalent of beet-lite borscht, etc.).

(Schedule/routine consistency is closely related for me -- sleepingpast my wake-up time is disastrous, as is insomnia, etc.)

5.My doctor has worked with me the whole time -- we upped metformin, and then got rid of it after the hypos. (My conditions are PCOS w/insulin resistance and Hasihmoto's thyroiditis, NOT type 2.)

6. Getting 15-30 min. of walking/light activity is helpful. Beyond that, no difference. Exercise makes it harder for me to keep my weight under control. I attribute this to stress.

7.If carb cravings are an issue, maybe try at least dietary sources of tryptophan. I really believe that insulin's effect on serotonin/melatonin levels is an obstacle when first going LC.

Don't bother w/LC substitutes besides vegetables. Believe in what works for you! For me, fat>protein, and I can't thinkabout calories at all. Whenever I've been at my thinnest, it's whenI've switched from half-and-half to heavy cream, from yogurt to sourcream, from turkey burgers to pan fried pork skins. It's been achallenge for me to recognize this pattern even though it's my ownexperience! But the last time I maintained weight on a whole-grain,vegetarian, low-fat diet I was twelve, so every day I have to remind myself to let that model go - it doesn't work for me, at least not now.

1. Did you make changes in your diet after you first reached your weight loss or blood sugar control goal? No, my diet is the same. It is a lifestyle. The 15 lbs I lost when I went low carb have stayed off for 3 years. My first diet change was gluten free in 2003.

2. How much weight have you regained at any one time and how did you deal with it? I have not regained since I started the low carb life.

3. How badly has your blood sugar gone off course? In the beginning I would cheat and my blood sugar would shoot over 200. I don't do that anymore. I try for fasting no higher than 90 and pp below 120. I am awaiting the results of my recent A1C

3. What behaviors did you adapt that helped you maintain your weight and blood sugar goals? Testing my blood glucose often to see what it was doing. Not having high carb snacks/food at home.

4. How high a carb level do you eat at? Does this level stay constant or does it fluctuate? I try to follow the 6-12-12 rule of Dr. Bernstein. Honestly, dinner may go as high as 20 carbs from vegetables. I eat no grains or starchy stuff. I try to keep my carbs fairly consistent day to day.

5. Did you ever get help from a doctor with metabolic issues that helped with weight or blood sugar control after you first regained control? No! My doctor follows my hypothyroidism. No doctor ever diagnosed me with diabetes. For the past 40 years I have been told I am prediabetic. My last glucose tolerance test in 2001 spiked over 200 but my doctors were not concerned because my fasting was 85. My PCP has accepted my self diagnosis. Have to wonder if my "pre-diabetes" had anything to do with having to have coronary bypass?? Ya'think?

6. How important is exercise to your ability to maintain? I am terrible about exercise. I am active and currently doing Zumba and some strength exercises. I know it is important. I find diet easier than exercise.

7. What tips would you give people currently beginning the process of changing their diet to improve either weight or blood sugar control that might help them achieve successful maintenance? Read "Blood Sugar 101" and then read it again. Get Dr. Richard Bernstein's book "Diabetes Solution". Learn as much as you can as you can take control. Don't look at the changes in food as a diet - think of it as a lifestyle change. Stay in touch with others who are doing this - support is important - you are not alone.

1. Did you make changes in your diet after you first reached your weight loss or blood sugar control goal?

No, I made dietary changes before I achieved my weight loss and blood sugar control. They were absolutely critical for me to achieve my goals.

2. How much weight have you regained at any one time and how did you deal with it?

I haven't regained more than 1 or 2 lbs at a time thus far. I deal with it by not worrying about it very much and realizing that day-to-day or week-to-week fluctuations of a pound or two happen commonly and aren't a reason to worry.

3a. How badly has your blood sugar gone off course?

I'm so carb restricted now that my body is used to using fat and gluconeogensis for fuel and not carbs. My insulin production is down regulated. So, if I eat too many carbs, i.e. more than about 20, at any one meal, I will get a sugar spike above 150 because my body just isn't used to needing much insulin. It's how I tell that meal just isn't a good one for me. When I stick to my low carb, paleo, gluten-free diet, my blood sugar is rock solid stably normal now off all meds.3b. What behaviors did you adapt that helped you maintain your weight and blood sugar goals?

4. How high a carb level do you eat at? Does this level stay constant or does it fluctuate?

I generally eat less than 30 carb grams per day. Some days it might approach 50, but spread out in different meals always. The only carbs I eat are in low fructose fruits like berries, paleo ok carbs like sweet potato, 80-90% cacao chocolate, and green veggies...plus the little bit in nuts and seeds.

5. Did you ever get help from a doctor with metabolic issues that helped with weight or blood sugar control after you first regained control?

No, I needed weight loss surgery and a strict diet to gain control. Now that I have control, I've learned enough while on the journey to maintain just fine on my own.

6. How important is exercise to your ability to maintain?

It helps a little, but I think it's minor compared to good diet and good sleep.

7. What tips would you give people currently beginning the process of changing their diet to improve either weight or blood sugar control that might help them achieve successful maintenance?

I think most people that have successful at loss to the level of really becoming a normal weight person, i.e. not just losing a bit of what they need to lose, and have lost all they really need to lose will do fine with maintenance without much help. It's so hard to lose in the first place and you have to learn so much about what works for you as an individual, that you'll know your body well enough at the end of the journey to do just fine with maintenance which is MUCH easier than loss.

1. No I've maintained weight and blood sugar control for over 3 years with a low-carb diet.

2. I have lost 45 pounds since diagnosis a little over three years ago. Still losing a pound or so every couple of months. Want to step it up and lose another 25 this year.

3. My blood sugar has never gone off course significantly. Occasionally I'll eat something new and not know how it affects sugar so I test and find out I'm high and don't eat that anymore.

3. Behaviors are simply maintaining low carb eating. I don't exercise much at all because of physical disabilities.

4. I stick with 25 or less per meal.

5. Started with an endo. Now use family doc. Went to diabetic education center once and never went back. They told me to eat way too many carbs.

6. Exercise is not an issue in my maintenance of weight and blood sugar control. I don't exercise at all because of physical disabilities (I use a power chair and a motorized mobility scooter). I do go outside and play with the dogs several times a day.

7. Count carbs. Test often (before, 1 hour after and 2 hours after). Keep a list of foods that don't spike blood sugar. After a few months, you'll know what you can eat and not. Then about once a month test often for a couple of days to make sure nothing's changed. And also test often when trying new foods.

1. Did you make changes in your diet after you first reached your weight loss or blood sugar control goal?

I allowed myself the rare "off" day but pretty much stayed at less than 30 carbs a day.

2. How much weight have you regained at any one time and how did you deal with it?

Cancer/surgery/chemo threw my diet for a loop and I regained about 45 pounds very quickly. It took me a LONG time (over a year) to really get back on the low carb train but now I've lost about half of that and my numbers are really good.

3. How badly has your blood sugar gone off course?

Steroids during chemo took it over 300. But it would slowly go back down over a few days and my A1C was, I believe, 6.4 for that period of time.

3. What behaviors did you adapt that helped you maintain your weight and blood sugar goals?

Eat less than 30 carbs a day. Take metformin 2x/day - dosage of 750 mg. I joined a gym after recovering from the cancer and now swim, do cardio, or work out most days of the week. If I test after dinner and it's too high for me, I get on an old exercise bike someone gave me and ride for 20 minutes - that will usually take the numbers down quickly. I try very hard to stay away from all processed foods and all that "white" stuff.

I wish I could find a doctor who wouldn't blow me off when I say that I want to be on some sort of insulin regimen so I don't totally burn out my pancreas, but no luck so far with that.

4. How high a carb level do you eat at? Does this level stay constant or does it fluctuate?

99% of the time it's 30 grams or less a day. Sometimes the compulsion/craving/weakness/whatever just sort of overcomes me and I give into something usually very bad for me. Like Pad Thai or spaghetti. Even brisk walking and a bike ride and any other exercise I can stand to do won't take me down off a Pad Thai high bg and I pay the price for days. So generally, the number is constant but maybe once a month I eat something I shouldn't.

5. Did you ever get help from a doctor with metabolic issues that helped with weight or blood sugar control after you first regained control?

Any doctor I've talked to about this can hardly believe that I HAVE diabetes (usually in the mid 5's for A1Cs) and are not willing to discuss anything further about it. They have all adhered to thinking that the ADA guidelines are what I should follow (NOT!!!!) and they all think that eating a low carb diet is dangerous. One endo told me that it was dangerous for me to try to achieve normal bg levels. She had no answer as to why having normal numbers was bad. I do not believe in doctors any longer around this issue. I depend on the copious amount of reading that I do and all the testing that I do. I try something and if it works for me I incorporate it into my way of living. Sure wish I could go to Dr. B... I bet he'd understand that I'd like to have more than 3 green beans without spiking over 100!

6. How important is exercise to your ability to maintain?

Crucial. I love to test before and after cardio and that really gives me quick positive feedback plus helps me lose weight. For me, the key to losing weight is controlling my numbers and walking or biking or swimming (can't run) are the ways that I maintain those numbers.

7. What tips would you give people currently beginning the process of changing their diet to improve either weight or blood sugar control that might help them achieve successful maintenance?

Read! Read everyone's opinion, try things out, find out what works for you. Don't rely on doctors to tell you how to achieve normal numbers - most of them just do not get it! Find other people who do low carb, even if it's only online. Prepare for people to tell you that you are doing dangerous things to your health because you eat low carb instead of low fat. Oh my, I could go on and on!

I don't qualify for the poll because I lost weight last year and have been stable for 4 months - I'm a total of 14 months since Diagnosis. But I found the post such interesting reading, I figured I'd write - and if it gets thrown out, so be it.

Since that point, I've lost 85 pounds, and went from "obese" to "normal" - At 42, the first time in maybe 30 years I was a normal weight - A change that allows me to walk by people I haven't seen in years, say hi, and have them mystified as to who I am.

I completely overhauled my caloric intake to get blood sugar control - mostly with quantity reduction, but also some tradeouts

A1C was 8.5 at diagnosis, has been 5.5, 5.8, 5.5 since - the last two without any meds which I bailed on (Janumet, Glimipiride) the last day in April.

My current diet hits an average 200g of carbs per day - I test twice (on average) and it seems to be the "per meal" carb that raises things - spreading out even meals keeps control pretty good. 800 calories per meal is a good total, 1000 calories almost always pushes the BS over 150 for a little while.

Everything I eat is logged in myfitnesspal, and most "bad" foods are weighed on the kitchen scale to ensure that I'm not kidding myself about portions. These are my two best friends in my new found health.

I seem to exercise quite a bit more than the other posters, however. I do cardio work 4 days a week on average, and Sunday ran my first ever Half Marathon in sub 2 hours - the heavy exercise definitely allows more carb intake than I could handle otherwise.

I never deprive myself of a food that I really want, but you can't maintain strict calorie control and eat too many pieces of chocolate cake!!! So you eat smaller portions.

I'm curious why limit the poll to people only using a low carb strategy, As a person who is diabetic and has used this forum to educate diabetics and non-diabetics alike, I would think you would want to hear from people who has used any number of healthy strategies in controlling diabetes.

I'm asking about low carb strategies because I'm working on a book about the realities of low carb dieting, both positive and negative and wanted to hear from people who had made it work for them.

Readers of my diabetes book know that I don't tell anyone what diet to eat, but suggest they use their meters to find out what works for them. Based on my earlier polls and the email I get every day, many people with diabetes do find cutting carbs helpful, but how much they cut and what they eat varies greatly from person to person. Hearing people explain what works for them illuminates this. But since I'm not working on a book about all diets, but only on one about cutting carbs, (which is already longer than the allotted page length) I have to stay focused on my topic.

I dont quite qualify for the 3 years as its only been 2.5 yeras since my T2 dx. I dont do a formal LC but I have done moderate carb since dx to getgreat BG control and I use the old eat to my meter & portion control. On the LC thing it is low carb compared to pre dx and its usually in the 100-150g a day range I would sayy. I'm not on any meds for D and my A1C was mid 6's at dx.

1. Did you make changes in your diet after you first reached your weight loss or blood sugar control goal? I made changes as I went I moderate my carbs level to get really good BG control. As I lost weight and excercised more I found I could tolerate more carbs.

2. How much weight have you regained at any one time and how did you deal with it?Around 7kg (15lbs) excercise & count calories.

3. How badly has your blood sugar gone off course?Nanda none - my A1c has been between 5.2-5.6 since dx. My highest BG after my meals are most often 7 (126) max with a few upto 7.8 (140) for a short time and once in a blue moon up around 8.5 (155) but that is is so rare and when I have over done like for example Christmas day.

4. How high a carb level do you eat at? Does this level stay constant or does it fluctuate?I would say most days 100-150g spread throughout my 3 main meals and snacks.

5. Did you ever get help from a doctor with metabolic issues that helped with weight or blood sugar control after you first regained control?No really I see my GP semi regular and I'm on a low dose ACE for BP that is now totally normal. But I find diabetes to be very very patient driven.

6. How important is exercise to your ability to maintain?It is very very important without I would think I would possibly be on meds.

1. Did you make changes in your diet after you first reached your weight loss or blood sugar control goal? 2003, low carbed, lost upward forty pounds fat and added about 20 lb muscle. Three years later Retinopathy and BG issues appeared. A1Cs about 5.7 (probably much lower than pre-low carb)

2. How much weight have you regained at any one time and how did you deal with it? A likely bout of statin poisoning led to two years of serious peripheral neuropathy and a chronic fatigue like syndrome. I gained 20 pounds, but maintained muscle, and t-shirt/shorts sizes which had dropped two size categories went back up but only one size. I am now losing weight again, mostly by stopping snacking. Protein snacks can be fattening.

3. How badly has your blood sugar gone off course? About 90% of the time I am 70-110, A1Cs 4.8 to 5.1.

3. What behaviors did you adapt that helped you maintain your weight and blood sugar goals? Exercise has been essential, I did not change diet during above session with statin ;poisoning, but had to greatly reduce exercise. Low carb has been consistent, and outside a little slack at holidays I have never gone off diet.

4. How high a carb level do you eat at? Does this level stay constant or does it fluctuate? 20-35 carbs a day, more if active all day - museum touring, heavy extended exercise. While I am a type 2 I think I produce no insulin. At Christmas I had a large bowl of clam chowder - zoomed to a high of 200. (about once a month I go over 160)

5. Did you ever get help from a doctor with metabolic issues that helped with weight or blood sugar control after you first regained control? no

6. How important is exercise to your ability to maintain? very

7. What tips would you give people currently beginning the process of changing their diet to improve either weight or blood sugar control that might help them achieve successful maintenance? Activity can be helpful. But only if you can do it, and like doing it. As for dieting, you have to come up with an eating pattern that makes you happy about what you eat.

I am relatively newly diagnosed so I don't qualify for the official poll but I hope this comment makes it anyway:

In 3 months I have gone from uncontrollable high readings in the mid-300s (which ultimately required hospitilzation from ketoacidosis) to waking readings of @100 (had my first in the 90s this morning!) and always PP readings under 120.

The merry-go-round of meds didn't do it, but a combination of low-carb, Dr. B, eating to my meter and raw food (there are some great documentaries available) did directly and almost exculsively result in these improvements.

I am now just well enough finally to begin serious exercise, but you can eat still low-carb when you are weak and feel like crap :) So that's what I did while trying to recover and the BG improvements were immediate.

So if you are reading about low carb for the first time, there is hope and there are better days ahead. Read Jenny's book and blog, and check out the numerous resources available online. Because you aren't going to get it from most doctors (I didn't from 3 different Endo's nor 2 CDEs.)

1. Did you make changes in your diet after you first reached your weight loss or blood sugar control goal?

I made changes before weight loss (weight loss was a consequence of these changes) and blood sugar control goal - I began the changes immediately after I was diagnosed in October 2005. After reading Jenny's blog in 2008, I became more systematic at it. I came down from a peak of 72 kg to around 64 kg now.

2. How much weight have you regained at any one time and how did you deal with it?

Whenever I go on vacation to India I gain a couple of kgs, as it happened during this Dec-Jan period. It seems to be taking some time to get rid of this 2 kg gain.

3. How badly has your blood sugar gone off course?

Not much -- the A1c's during the early days of diagnosis were a little over 6% - 6.1 to 6.3%. Now they are around 5.5, varying between 5.3 and 5.8%. 1 hour post prandial BGs are normally below 7.6 mmol/L but rarely, and when I take an exceptionally high carby meal, it may shoot up as high as 9 mmol/L. 2 hour PP readings are normally below 6.6, but again, once in a while they may approach 8.

3. What behaviors did you adapt that helped you maintain your weight and blood sugar goals?

Reduced my food intake (not just carbs.) Carb consumption has come down from perhaps 400+ grams per day pre-diagnosis to around 180-200g per day now. Also, began doing regular exercise.

4. How high a carb level do you eat at? Does this level stay constant or does it fluctuate?

I try to keep it around 180g per day but it fluctuates - some days it is quite more.

5. Did you ever get help from a doctor with metabolic issues that helped with weight or blood sugar control after you first regained control?

Not after I regained control. At diagnosis my doctor prescribed Metformin which I continue to take. I have a family doctor who continues to prescribe Metformin and order A1c and lipid panel tests.

6. How important is exercise to your ability to maintain?

Very important. It has helped me control BG, lose weight, build muscles, and of course keep fit and improve general health.

7. What tips would you give people currently beginning the process of changing their diet to improve either weight or blood sugar control that might help them achieve successful maintenance?

Find out what works for you by experimenting with your diet, using your meter, noting your lipid levels during periodic lipid panel tests, and being aware of your perceived feeling of fitness and general health.

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I was diagnosed with diabetes in 1998. Since then I've kept my A1cs in the 5.0-6.0% range using the techniques you'll find explained at The main Blood Sugar 101 Web Site, where you'll also find extensive discussion of the peer-reviewed research that backs up the statements you read here.

I've also published two books on related subjects, Blood Sugar 101: What They Don't Tell You About Diabetes, which was an Amazon Diabetes bestseller for 3 years and Diet 101: The Truth About Low Carb Diets.